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Teaching hospitals short on specialists

By Katie BurnsPosted July 15, 2006

As veterinary specialists leave academia for practice, teaching hospitals are struggling to provide some parts of clinical education to students as well as residents—the next generation of specialists.

Hospital directors and department heads discussed the issue this spring during the annual meeting of the American Association of Veterinary Clinicians. The AAVC and the Association of American Veterinary Medical Colleges will host a symposium this fall on "Veterinary Teaching Hospitals and the Future of Clinical Veterinary Education."

"The growth in the clinical specialties, and the demand for those services in the private sector, has driven a market that brings into question the sustainability of our current teaching hospitals," said Dr. Cecil Moore, president of the AAVC.

Dr. Moore, also chair of the University of Missouri-Columbia Veterinary Medical Teaching Hospital, said part of the problem is that universities don't pay specialists the same salary as they can earn at private practices—especially at state schools where revenues aren't keeping up with expenses.

Reviewing the situation

Dr. John A.E. Hubbell, a professor at The Ohio State University in the Department of Veterinary Clinical Sciences, said pet owners are willing to spend the extra money to take their animals to specialists. But a specialty practice in town might be more convenient for clients than the university teaching hospital. The result is the teaching hospital loses some of its caseload as well as faculty.

"There's a great concern among colleges of veterinary medicine about maintaining the veterinary teaching hospitals as centers for learning and research," Dr. Hubbell said.

The AAVMC surveyed veterinary colleges on the subject of specialists in 2005. The survey revealed needs in anesthesiology, radiology, oncology, and ophthalmology.

Dr. Hubbell said many colleges are looking at a distributive model for some part of clinical education. Western University of Health Sciences in California has no veterinary teaching hospital. Other colleges send students off campus to private practices, animal shelters, or farms.

Some specialty practices offer residency programs. In other cases, colleges are operating or partnering with specialty practices to increase the caseload for their residents.

Examples of change

Dr. Mimi Arighi, director of Purdue University's Veterinary Teaching Hospital, said the School of Veterinary Medicine has an affiliation with an emergency clinic in another area of Indiana. The hope is to hire specialists for the clinic, which would allow Purdue specialists to consult and Purdue residents to see a broader caseload.

And Purdue is trying other solutions to address the loss of specialists in academia and simultaneous growth of the specialties. The veterinary school shares specialists with the University of Illinois College of Veterinary Medicine, for instance, and sends some students to the Indianapolis Zoo to learn exotic animal medicine.

In general, Dr. Arighi said, more and more students receive a portion of their clinical training in private practice. Most residency programs are still at teaching hospitals, though. The challenge remains to recruit and retain teachers from among the specialists.

A 2005 survey of diplomates of the American College of Veterinary Surgeons explored why many members of that group prefer private practice to academia.

The surgeons cited salary and location as reasons to work in private practice. Surgeons also indicated that university administrators recognize research and teaching but not clinical service, and being excellent in all three areas is difficult.

"Some people just don't want to do research," Dr. Arighi said. "They prefer just teaching and surgery, and some of them just like to do surgery."

The ACVS survey found that, between 1995 and 2005, 219 respondents changed from academia to practice and only 147 changed from practice to academia—including 14 who went to academia to complete residency programs.

Looking ahead

The symposium on veterinary teaching hospitals, from Nov. 9-11 in Kansas City, Mo., will bring together specialists and other stakeholders. The topics will fall under three headings—the teaching hospital of the future, the scope of clinical education, and meeting the demand for clinical educators.

More information is available through the AAVMC Web site at www.aavmc.org. Presentations about clinical education from the AAVC meeting are available at www.craiggroup.com/AAVC/reports.htm.